Friday, August 21, 2015

Cadillac Tax Notice 2015-52 and Related Ramblings

Most of the ACA focused on increasing the number of American's with access to health care, but the Cadillac Tax (aka Excise Tax) has a dual purpose. First the obvious, it helps pay for the expansion of coverage. It's expected to raise 87 billion. It's also expected that employers will shift benefit dollars into wages and that people will lose deductions for health care expenses that will raise another 202 billion. 

When I last blogged about the Cadillac Tax, I didn't understand this last item. It's noted in the Congressional Office Budget Report as "other which consists mainly of the effects of changes in taxable compensation on revenues." As I was reading the most recent IRS Notice, it clicked. The ACA isn't just banking on the revenue from the tax which most employers are planning to avoid, it's banking on the increased revenue that will come from the moves employers take to avoid the tax that result in increased taxable income to Americans. For example, if an employer eliminates and FSA that an employee has been putting $2,500 a year into that $2,500 becomes taxable income. 

Thursday, July 30, 2015

Finding the Safest Care

We have a new tool to help us find a good doctor -- The Surgeon ScorecardOf course, hospital safety matters and I've blogged about that before, but when it comes to elective operations, it is more important to select the best surgeon. The new scorecard covers common elective procedures -- knee replacement, hip replacement, gallbladder removal, lumbar spinal fusion, prostate resection, prostate removal and cervical spinal fusion. 

Monday, June 29, 2015

Commonly Used Medications Linked to Dementia

Cleaning out our medicine cabinet.
Every once in a awhile, I come across something that I want everyone I care about to read. The latest is a study that found a significant link between high use of anticholinergic drugs - including popular non-prescription sleep aids and the antihistamine Benadryl - and increased risk of developing dementia and Alzheimer's disease in older people.

Anticholinergic drugs block the action of acetylcholine which stimulates muscle contractions. They treat things like gastrointestinal problems, overactive bladder, respiratory disorders, insomnia, depression and allergies. Benadryl and Tylenol PM are commonly used anticholinergic that are sold over-the-counter. In the study, the drugs were found to have a cumulative effect that may not be reversible. 
You can view a list of anticholinergic drugs available by prescription on the Mayo Clinic Site. 

Wednesday, June 17, 2015

Does Your Organization Have a Glide Path to the Cadillac Tax?

A Skimm Style Cadillac Tax Primer

Photo by Glenn Beltz --
Aircraft approaches San Diego Linbergh Field at Dusk
What's the Cadillac Tax?
The ACA expanded health coverage to millions. The Cadillac Tax helps to cover the cost of the expansion by taxing employers that provide "high-cost" health coverage to their employees. AKA -- Excise Tax.

What's a Glide Path?
When I was at the World Health Care Congress, I heard big employers like Disney refer to a glide path. They've projected how the tax will impact them and have plans in place that will allow them to limbo under the tax thresholds (more on that later.) FOMO -- I want ASHA to have a glide path too.

Friday, April 24, 2015

Five Big Ideas from the World Health Care Congress #WHCC15

I had the good fortune to attend the World Health CareCongress. The event pulls together some of the most respected leaders in healthcare and shares the issues of the day from diverse perspectives. I walked away with pages and pages of tweets and notes. Way too much to summarize session by session. I decided to let it sit for a while and then come back to it and share the ideas I continue to think about. 

Tuesday, March 31, 2015

Defining What it Means to be an Engaged Healthcare Consumer

In the health and wellness arena, everyone is talking about engaging consumers, but are we clear about what we're asking people to do? As far as I am aware, no one has defined what specific behaviors an engaged healthcare consumer demonstrates. I’d like to create a definition that outlines how an engaged consumer behaves. I plan to share it with our staff to clearly communicate what we are asking them to do. 

If you’re interested enough to have read this far, I’d like your help crowdsourcing a definition. I’ll get us started and I hope you’ll jump in and use the comment feature to share your thoughts. 

Wednesday, March 11, 2015

Couponing for Prescription Drugs -- Guest Post by Reed Racette

Reed Racette published this article on LinkedIn and I'm sharing it here with his permission. Reed described his take on an experience he had from a customer service perspective, but it's just as illustrative from the perspective of managing prescription drug costs. In Reed's case, their pharmacist lead them through the process which is where the exceptional customer service came in. However, it's something you can do for yourself or a family member. I work with Reed's wife, Kellie, at ASHA and she told me the coupon they found covered the entire cost of the medication saving them more than $2,000. Many thanks to Reed and Kellie for sharing their story.