America's Healthcare Challenge

Each year insurance companies who participate in the ACA marketplace are required to post their proposed rate increases or their block of business in each state they operate in. These rates have been shown to vary widely depending on the year, however, they have stabilized for the most part recently. This segment breaks down the rate increases, informs you of how the companies determine these numbers and what you should do if you are in a situation where you are facing an undesirable rate increase.

Two heavyweights will be duking it out in the court system over problems with access to claim information as Kraft Heinz is suing Aetna over lack of access to critical data. Most large companies often self-insure their health plan. This means that they are responsible for paying claims up to a certain amount before separate insurance often kicks in called stop-loss. Since most businesses are not in the business of insurance they often partner with what is called a Third Party Administrator (TPA) to process and pay claims. Large insurance companies often also offer TPA services since they have the infrastructure in place. In order for this relationship to be successful it has to have transparency on both sides. Employers who are concerned about their healthcare costs will want to look at their claims history to see if there are any areas where they can control costs. The problem is when they are unable to get this information there is nothing they can do. This seems to be the heart of the issue between these two companies as Kraft Heinz is alleging that Aetna is withholding this important data. You can read more here... https://www.jdsupra.com/legalnews/kraft-heinz-sues-aetna-raising-novel-8183158/ https://www.benefitspro.com/2023/07/05/kraft-heinz-accuses-aetna-of-fiduciary-breaches-412-150903/

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We have reported previously on the ensuing crisis we face with regard to looming healthcare worker shortages. The biggest driver for this is demographics in that the baby boomer generation was much larger than other generations and as they continue to retire there may not be enough new workers to replace them. The system has failed to train more and now more angst from healthcare workers after the pandemic could exacerbate this problem even worse. We discuss these factors in this segment. Here is a link to the previous segment with more on this topic: https://soundcloud.com/americascanary/healthcare-clinicians-are-burned-out Here is the link to the article referred to in this segment: https://www.healthcaredive.com/news/healthcare-labor-trends-2023/641352/ FOLLOW ME ON ALL SOCIAL MEDIA PLATFORMS FACEBOOK: www.facebook.com/AmericasCanary LINKEDIN: www.linkedin.com/company/edbellis/ INSTAGRAM: www.instagram.com/americascanary/

In general, the Inflation Reduction Act of 2022 alters how the healthcare industry handles drug costs and Medicare. Other provisions expand the Affordable Care Act and prescription availability, including diabetic medicines and vaccines. Along with direct assistance, the Act attempts to improve everyone’s health and well-being by reducing environmental hazards. Like all things in healthcare, your benefits from the Inflation Reduction Act can vary wildly. Luckily, you can fare better if you understand how the provisions affect you personally. While only your lawyer can give you those specifics, by listening in to this segment, you can learn the basics of each provision so you will be better equipped when asking the experts. FOLLOW ME ON ALL SOCIAL MEDIA PLATFORMS FACEBOOK: https://www.facebook.com/AmericasCanary LINKEDIN: https://www.linkedin.com/company/edbellis/ INSTAGRAM: https://www.instagram.com/americascanary/

Actions You Can Take When Mistakes Are Made With Your Medication Eating the wrong thing, taking a wrong turn, and making a mistake in your medication are all unfortunate events that can happen to anyone. But what happens when you accidentally take a double dose of your medication? Or take it at the wrong time? Or get the dosage wrong entirely? Mistakes like these are more common than you might think—and they can have serious consequences. That's why it's so important to understand how to avoid mistakes in your medication and what to do if you make one. Here are ways to prevent these mistakes and what to do if they occur: 1)Don't take medication too often. Taking too many medications at once can lead to side effects, confusion, and in some cases, a life-threatening reaction. If you're on more than one medication, make sure you know how they interact with each other and that your doctor is aware of everything you're taking. 2) Take your medications at the correct times. It's important to take all of your medications at their scheduled times, even if some of them are meant to be taken together with other medications or supplements on an empty stomach first thing in the morning or right before bedtime (for example). 3) Use due diligence when picking up a new prescription drug. When you pick up a new prescription, it's easy to rush through the process of getting it filled and head home. But if you're not careful, that haste could cost you. It's important to use due diligence when picking up a new prescription drug. 4) Make sure you receive the right dose of your medication. If you have been prescribed medication by a doctor, it's important that you take it exactly as directed—and not more than is recommended or less than is needed. This can be especially tricky if you have multiple prescriptions or if someone else has given them to you. Make sure that the pharmacist has given you all the correct doses for each medicine and double check. 5) Check with your doctor to ensure that you are taking the drug correctly. In order to avoid mistakes in medication, it's important to check with your doctor before taking any medication. This is especially true if you have been prescribed a new medication or if you are taking multiple medications at once. 6) Don't skip doses or miss doses on purpose for any reason. When you're taking medication, it's important to take it as prescribed. If you miss a dose or forget to take it, there's a chance that your body's not getting the amount of medication that it needs; this can lead to some serious problems in terms of your health. To avoid this, make sure you always have your medications on hand so that you can take them when the time comes. If you're having trouble remembering when and how much of your meds to take each day, consider writing down reminders in a planner or on sticky notes around the house. 7) Know what to do when you think you’ve made a mistake. If you think you've made a mistake with one of your medications—for example, if you took too much—it's important that you do something about it right away! If possible, call your doctor or pharmacist immediately; they will likely be able to tell if there is any danger from what happened and what steps need to be taken next. In addition, if there are any serious side effects from using too much of the wrong medication, they will be able to advise accordingly. KEY TAKEAWAY: Overall, everyone makes mistakes with medicine. It's a fact of life. The important thing is to be educated about your medications, to know what you are taking, and to make sure that you take them as directed. If you have questions or concerns, speak to your doctor as soon as possible to avoid any long term negative effects from a medication error. FOLLOW ME ON ALL SOCIAL MEDIA PLATFORMS FACEBOOK: https://www.facebook.com/AmericasCanary LINKEDIN: https://www.linkedin.com/company/edbellis/ INSTAGRAM: https://www.instagram.com/americascanary/

It's not always easy to talk to your doctor. Trust me, I know the drill. I have been to more appointments than most people my age. Once you get in the room you don't want to feel like you're wasting their time or asking questions that they've already answered a million times before, but you also want to make sure that you're getting the best possible care for whatever condition you're dealing with..... Here are seven tips for how you can make sure that your visit goes smoothly and that you get all the information and treatment options available to you. 😊 ☑️Before you even go to the doctor, start keeping a log of your symptoms. ☑️Don’t wait until the end of your visit to bring up something important. ☑️Don’t be afraid to ask questions. ☑️Don't be afraid to ask for a second opinion ☑️If you don't understand what the doctor is saying, speak up! ☑️It is ok to tell your doctor how you are feeling physically and emotionally ☑️Take Notes When Leaving the Office KEY TAKEAWAY: The best way to talk to a doctor is directly. Though it may not be easy, honest communication with your doctor will ensure that you get the best possible care. By knowing what to say and what questions to ask, you’ll gain a better understanding of any problems, as well as an action plan on how to proceed forward. After all, doctors are human beings—not gods—and they need the information they’re given in order to properly diagnose, treat or otherwise care for a patient. Hopefully, these tips will help you to have better experiences and more effectively communicate with your doctor in your next appointment. Want more tips? Follow E.D. Bellis for more. Or book an appointment with E.D. Bellis to learn more how to better navigate the complex healthcare system: calendly.com/edbellis Visit our website: edbellis.org #healthcare

How To Stretch Your Healthcare Dollar With so many things to spend money on, it can be hard to know where to save. One area to consider is your health care, since this is one of the overall most important areas of your life. Whether you're trying to save cash, or simply stretch your healthcare dollar, we will show you easy ways to do so. Know Your Plan You should know how much you pay for each visit, every prescription, and so on. If you're not sure what's covered by your insurance plan, contact your provider and ask for a copy of their plan details. If you have any questions about what the details mean or how they apply to you, ask them! The more information you have about what's covered and what isn't covered under your health insurance plan, the easier it will be for you to make informed choices about where and when to seek treatment. Don't Wait to Refill Medications Always try to refill medications before they run out so that you avoid paying full price at the pharmacy counter. Check with your doctor if you think this might be necessary: some drugs are only effective when taken regularly, and skipping doses can cause side effects or even lead to other medical conditions down the road (like high blood pressure or diabetes). In some cases, doctors may recommend that patients take a certain medication only once per day or every other day—if this is the case, ask them if there's something else available that would work well enough without requiring such strict adherence to a schedule (or just skip it altogether). Keep an eye out for discounts If you have insurance, check with your provider to see what discounts they offer. Some may be as simple as a discount card that can be used in certain places, while others might require that you get your insurance through a particular company or network. Your provider should also be able to tell you about any other ways they offer discounts in exchange for using specific providers or services. Ask about generic drugs Generic drugs are just as effective as name brand drugs, but they cost less because the companies that make them don't have to spend money on research and development. If your doctor prescribes a generic drug, ask whether there's an alternative on the market that's less expensive than the one he or she has recommended. Visit a retail clinic for routine care Retail clinics are popping up all over the place these days—you might not even realize how many of them there are in your area! These clinics provide low-cost care at convenient locations such as grocery stores and pharmacies. For example, if you're feeling ill but don't want to go into an emergency room or urgent care center where treatment is more expensive (as well as more impersonal), try heading over to one of these retail clinics instead! Pay attention to your bills and statements. Health insurance is about more than just paying for care. It's also about paying for the paperwork that goes with it, and that can add up. Make sure you're keeping track of all your statements, and reviewing them regularly so you know what's going on with your coverage. You'll also want to make sure that your provider has the correct information about you—that includes your address and phone number, as well as any information they might need to treat you, like allergies or medical conditions. Finally, when shopping for a policy, think about the worst-case scenario. This might seem counterintuitive—after all, isn't the point of insurance to protect you from worst-case scenarios? If something does happen, though, it's important that you're covered for every possible outcome of that event (and any unexpected complications).

"The medical system is responsible for a surprisingly large percentage of greenhouse gas emissions, and the toll is especially heavy in the U.S. The health care industry “is among the most carbon-intensive service sectors in the industrialized world,” accounting for between 4.4% and 4.6% of greenhouse gas emissions, according to a key paper on this topic, published in 2020 in Health Affairs. In the United States, the toll is particularly heavy. It’s estimated that the health care sector produced about 8.5% of domestic greenhouse gas emissions in 2018, according to that paper. It also notes the U.S. medical system may be responsible for about a quarter of all global health care greenhouse gas emissions, which is more than the health care system of any other nation." You can read more at the link below if you want. 😊 Or you can hear my thoughts about this on an upcoming episode of America's Healthcare Challenge. I will be talking about what changes could be made and HOW they could happen. What other countries are doing? Who is leading the industry in addressing this issue? Will this ultimately lead to higher healthcare costs? What are your thoughts on all of this? Share in the comments below. Full article here.. https://bit.ly/3C0KlJu

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1) Infrastructure Bill's Top Provisions. 2) Biden's Vaccine Mandate and Blowback 3) Merck in the Money? 4)Drug Companies Making Bank 5) Positive News on a New Cancer Treatment

President Biden mandated that businesses with more than 100 employees mandate the COVID-19 vaccine or require workers to be tested regularly. This has created blowback all over the country and several outlets are worried about the impact on the healthcare workforce. Also, as this pandemic drags, could we now have a new treatement?

President Biden outlined his six point plan to battle the COVID-19 Delta Variant. This segment looks at some of the important provisions including a controversial Department of Labor requirement for businesses with more than 100 employees facing a $14,000 penalty for un-vaccinated employees who deny testing.

As kids head back to school new concerns have surfaced about the Delta variant that is increasing hospitalizations rapidly across the country. The difference here is that it is affecting children more than other strains. Will the six-point plan outlined by the President be able to slow the spread? We discuss in this segment.

Breaking news today as the United States Supreme Court sided with the Federal government and upheld the constitutionality of the law. In this segment we discuss the historic 7-2 decision, share reaction from President and talk about the five things we may see now that the law is here to stay.

In this exclusive webinar, we discuss the latest futuristic healthcare developments catching our attention as in 2021 along with the major healthcare legislation passed in the last decade. For more information on the content discussed in this webinar make sure to hit us up here by filling out this survey: https://docs.google.com/forms/d/1GgEhVD0yXnsaKZ9ExQMGKGYI5797X7R6Xf1FhS5GvGs/edit

States all over the country drop mask mandates and numbers continue to decline as vaccinations increase. Some are questioning their effectiveness as others appear to need reprogramming into not wearing a mask. The recently released Fauci emails reveal inconsistencies on this requirement people are starting to ask questions about this and the origins of the COVID virus. As the once revered, Dr. Anthony Fauci answers tough questions about his emails, his critics such as Senator Rand Paul (R-KY) continue to question his credibility.

For the first time in nearly two decades, the Food and Drug Administration (FDA) has approved a drug to treat the horrible disease known as Alzheimer's which affects 6 million Americans right now and is expected to impact 13 million within the next 30 years. This new drug called Aducanumab and developed by Biogen targets the plaque that affects brain cells and was approved amidst some controversy. In this episode we cover this breaking news and play clips from the Biogen CEO who defends the $56,000 annual price. As a bonus in this segment we discuss how you can capitalize on rebate programs to save thousands on cost sharing expenses. For more visit our facebook page: facebook.com/americashealthcarechallenge

As the COVID Pandemic Refuses to Surrender those on the front lines of the healthcare delivery system are facing burnout and recently 4/10 indicated they may leave the industry. We discuss this and some of the factors contributing to this burnout in this segment.

After coming to market as a game changer the Johnson and Johnson vaccine which only requires one dose has been paused over blood clot concerns similar to their counterpart AstraZeneca. While this looks to be a temporary hiccup, this could slow the path towards herd immunity. Plus the top stories of the week and the top ten dangers of digital health.