To The Agent and Consultant Briefing Archive

Agent and Consultant Briefing: November 2010

On My Mind by Cheryl DeMars, President and CEO will return next month. This month we are running a guest column from Richard L. Brown, MD, MPH, a professor of family medicine at the University of Wisconsin School of Medicine and Public Health, clinical director of the Wisconsin Initiative to promote Healthy Lifestyles (WIPHL), and CEO of Wellsys, LLC.

Behavioral Screening and Intervention (BSI) in Healthcare Settings: Improve Employee Health and Reduce Costs Now

Richard L. Brown, MD, MPH

Ensuring the individuals you cover routinely receive behavioral screening and intervention (BSI) in their health care settings is one strategy for cutting costs and improving employee health.

BSI involves:

• Screening all patients in health care settings for tobacco use, excessive drinking, illicit drug use, and depression with a quick questionnaire.
• Asking further questions of patients with a positive screen to gauge the severity of their risk or problem.
• Referring patients with severe problems for specialized assistance.
• Providing on-site interventions for patients with mild to moderate risk or problems.

Here are a few ways BSI can lower costs for employers:

• About 30 percent of Wisconsin adults engage in risky and problem drinking, and most are employed full-time. Most of these individuals respond affirmatively to screening questions, and many decrease their drinking after 5 to 20 minutes of discussion and perhaps a follow-up session or phone call. The National Business Group on Health concluded that brief interventions generate a 20 percent reduction in ER visits, a 37 percent decline in hospitalizations, and nearly 50 percent decreases in car crashes and arrests. A few studies suggest that BSI is effective for drug use, as well, and most drug users are employed full-time, as well. Alcohol screening and intervention yields a return on invest (ROI) of 4 to 1 within 12 months. 
• Depression screening, intervention, and referral are effective, too. When these services are delivered systematically, more depressed patients are recognized and treated effectively. Impacts include net decreases in healthcare costs and increases in workplace productivity. Depression screening and intervention yield an ROI of 3-to-1 over 2 years. 
• BSI has been proven to improve tobacco quit rates from 3 to 6 percent. When tobacco users also reliably receive optimal intervention services, quit rates improve to over 25 percent. ROI is more delayed but even greater for tobacco services.

What can you do to ensure your employees receive these services?
BSI is recommended by the U.S. Preventive Services Task Force, the National Commission on Prevention Priorities, the National Institutes of Health, the Centers for Disease Control and Prevention, and many others.

• Make sure your benefit plan covers these services. Services should be reimbursed:
• When delivered by paraprofessionals under the supervision of credentialed providers
• When credentialed providers deliver another service at the same visit,
• And are exempted from direct charges to patients.
• Ensure that BSI is provided systematically at the clinics, emergency departments and hospitals where your covered individuals are seen. 
• Find out more about the Wisconsin Initiative to Promote Healthy Lifestyles at www.wiphl.com. 

WIPHL has been working with twenty health care settings — from urban Milwaukee to small towns up north — to deliver alcohol and drug screening and intervention services. WIPHL has helped those settings expand their health care team with dedicated, cost-efficient paraprofessionals, who deliver most of the services according to research-based protocols. 

These settings have screened 90,000 patients and delivered 18,000 interventions. Patients and providers are very happy with the services. Episodes of excessive drinking have decreased by over 20% — enough to generate the declines in health care utilization found in previous research.  Regular marijuana use has decreased even more.

WIPHL has recently integrated cutting-edge depression services into primary care settings. So far 27 patients have rated our services very highly and experienced a 47 percent reduction in symptoms in 4 to 6 weeks — without any new medications.

Please join with me to make BSI a standard of care in all health care settings.

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IRS Makes PPACA W-2 Reporting Optional for 2011

From the American Benefits Council
On October 12, the Internal Revenue Service (IRS) released a new draft Form W-2 for 2011 along with Notice 2010-69, guidance indicating that the agency will defer the new requirement for employers to report the cost of coverage under an employer-sponsored group health plan, making that reporting by employers optional for forms issued for the 2011 tax year.

Under the Patient Protection and Affordable Care Act (PPACA), employers are required to report the cost of coverage under an employer-sponsored group health plan on the Form W-2. This reporting requirement was intended to provide employees with greater transparency into overall health care costs. Under the statute, employers are instructed to use rules similar to COBRA valuation rules to determine “aggregate cost.”
 
According to Notice 2010-69, "The Treasury Department and the IRS have determined that this relief is appropriate to provide employers with additional time to make any necessary changes to their payroll systems or procedures in preparation for compliance with the reporting requirement." Although reporting the cost of coverage will be optional with respect to 2011, to quell rumors to the contrary, the IRS continues to stress that the amounts reportable are not taxable. Additional guidance on this issue is expected to be provided before the end of 2010.

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Information from the Department of Labor on PPACA

If you haven’t yet, you will want to visit and bookmark the U.S. Department of Labor website. The site includes regulations, guidance, and model notices and is being updated regularly. They recently released FAQ Part II and Part III related to grandfather status and other issues, as well as model notices in Spanish.

Department of Labor E-mail Alerts:
You can also sign up up for e-mails from the DOL when the site is updated. To do so, visit this link and click on Department of Labor updates by e-mail. You will then need to enter your e-mail information and optional password information. On the next screen, scroll down to Patient Protection and Affordable Care Act under Employee Benefits Security Administration and check the box.

Also, be sure to view our PPACA Updates page for more on this legislation.

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Annual Meeting Celebrates 20 and Discusses the Behavioral Economics of Health Care

More than 100 people made their way to the Monona Terrace October 26, for The Alliance Annual Meeting. We celebrated 20 years as a cooperative, elected board members and saw two informative presentations on the topic of behavioral economics. Understanding behavioral economics is essential in making sense of the irrational decisions individuals make about their health. Studying behavioral economics helps predict these decisions, and can help employers steer employees to make better choices about their health.

The two presentations on behavioral economics by Murat Kalayoglu and Jack Towarnicky are outlined in the executive summary that provides a more in-depth overview of the topic information. You can also find copies of the presentations and additional handouts from today’s meeting on The Alliance website In The Circle.  

The membership voted on a bylaw change giving the Board of Directors the authority to amend bylaws. We are pleased to announce the election of three new Alliance board members:

Bill Jollie, Vice President Health Care Service and Value, WEA Trust
Kyle Reading, Vice President of Finance, Spuncast, Inc.
Mary Kay Brooks, General Manager, Corporate Attorney and Owner, Brooks Tractor, Inc.

And the re-election of:

Jennifer Pagels, Manager – Human Resources, Trek Bicycle Corporation
Ed Herrman, Director of Human Resources, Monroe Truck Equipment
Michael L. McDonald, V.P. Human Resources, Safety, and Communications, Foremost Farms USA

We hope you will join us in welcoming our newest and returning members whose dedication and direction will help The Alliance move health care forward.

If you attended and have not yet completed our survey, you may still do so.

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Workers' Compensation: Healthy People at Work

The Alliance can help employers struggling with the costs of workers' compensation claims. By providing access to The Alliance's comprehensive, cost-efficient network of providers they can manage these claims' costs. Savings vary from employer to employer, but participants in the Healthy People at Work program experience average gross savings of 30.1% on compensable billed charges.

Learn more or contact Jesse Oberloh, 800.223.4139 x 6645.

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National Network Access for those Outside The Alliance Service Area

The Alliance's partnership with National Health Benefits Corporation (NHBC) provides a cost-effective solution for national network coverage for employees who travel or have dependents living in locations outside The Alliance service area.

The National Access Program includes deep discounts and a large number of available hospitals, facilities and physicians.
 
Guarantee to Alliance Members
As part of The Alliance's partnership with NHBC, the National Access Program offers significant savings, extensive access, and superior customer satisfaction. We have also secured guarantees that protect you from lost discounts and ensure that third-party administrators adhere to their responsibilities. 
 
Learn more about the National Access Program and these guarantees. For product specifics and pricing, contact Kate Wakefield, NHBC, 888.621.7900.

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Another Member Benefit: Stop-Loss Discounts

Your membership in The Alliance gives you access to discounts on stop-loss coverage. We are able to bring you this preferred pricing by leveraging the collective purchasing power of our member companies.

More than twenty-two reinsurance carriers have agreed to offer discounts for employers that are members of The Alliance. The discounts are based on a thorough evaluation of our contract effectiveness with health care providers and facilities. Employers can access the complete list in the Employer Resource Center.

Once they log in, they should visit Preferred Pricing under Employer Tools. If they don’t know their log-in information, they may contact Tierney Jensen, 800.223.4139 x 6642.

For specific details on the stop-loss discounts, you may contact Jesse Oberloh, 800.223.4139 x 6645.

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WisconsinRx/National CooperativeRx Negotiates Improved Pricing with CVS Caremark

We recently received news that WisconsinRx/National CooperativeRx renegotiated their contract with CVS Caremark a year earlier than planned. The new and significantly better financial terms are available to their members as early as January 1, 2011 (upon each member signing an amendment to their existing agreement).

The PBM negotiation and resulting pricing is just one of the ways WisconsinRx/National CooperativeRx ensures that its pricing is best-in-class. The new deal also shows CVS Caremark’s commitment to support the cooperative’s clinical initiatives, as additional dollars will be available to implement programs for their members that help ensure they receive the right drug at the right time and the right place.  

The improved pricing is just one of the benefits of belonging to WisconsinRx/National CooperativeRx:

• In August, they distributed $828,930 in additional rebates to members from the 95% annual true-up guarantee component of their contract, in addition to the $7 million of aggregate average annual guaranteed rebates paid out during the year.
• In September, they distributed $576,062 in patronage dividends to members.
• Finances are solid and net earnings, which are returned as patronage refunds to members, are ahead of budget.
  

To learn more about Alliance preferred pricing from WisconsinRx/National CooperativeRx, contact Bobbi Jones, product management specialist, 800.223.4139 x 6638 or visit WisconsinRx/NationalCooperativeRx’s website.

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AHRQHealthTV Videos

The Agency for Healthcare Research Quality (AHRQ) consumer health videos are now available on AHRQHealthTV, a free channel available on YouTube.

Recent videos show how to keep track of medicines, tips for going home from the hospital, and asking questions before surgery.

Users can subscribe to videos to receive information about the latest updates.

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New Spanish Language Consumer Guides

AHRQ has also released eight new free evidence-based guides designed to help Spanish speakers understand and compare the risks, benefits and side effects of treatments for eight health conditions. The guides provide valuable information that patients can use in talking with their clinicians. Topics include:

• Premixed Insulin for Type 2 Diabetes: A Guide for Adults
• Treating High Cholesterol: A Guide for Adults
• Osteoarthritis of the Knee: A Guide for Adults
• Gestational Diabetes: A Guide for Pregnant Women
• Having a Breast Biopsy: A Guide for Women and Their Families
• Radiofrequency Ablation for Atrial Fibrillation: A Guide for Adults
• Reducing the Risk of Breast Cancer With Medicine: A Guide for Women
• Thinking About Having Your Labor Induced? A Guide for Pregnant Women 
  

Read more about these and other Spanish language consumer guides. 

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Welcome Dan Stahl

Dan Stahl joins The Alliance as the new human resources consultant. Dan has been president of the Human Resources Group since 2002, consulting small- to medium-sized employers. He comes to The Alliance with nearly nineteen years of HR experience, working in six divisions of health care for Pfizer. Dan will provide The Alliance consulting and human resources support.

Please join us in welcoming Dan, 800.223.4139 x 6620.

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Building our Cooperative

Please join us in welcoming the following new member to our cooperative:

Innovative Ag Services
Innovative Ag Services was formed in 2005 from the previous agriculture division of Swiss Valley Farms, Co. The agriculture division began in 1969 and is currently serving approximately 2,200 farmer members. Innovative Ag Services specializes in crops, livestock inputs and grains, achieving close to 450 million in annual sales. Innovative Ag Services joined The Alliance in October.

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Alliance Provider Update

The Alliance encourages employers to distribute the monthly Provider Update listing to their employees.

Just a reminder: Always check the online provider directory for the most current provider information!

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QualityCounts™ for Employees

The Alliance encourages employers to distribute the monthly QualityCounts for Employees informational piece to their employees.

This month, These stuffers can be used as part of regular payroll mailing or as mailbox reminders to get the word out about QualityCounts™. 

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News You Can Use

Each month, The Alliance highlights health care and benefit management news for employers in News You Can Use, with a link to take you to the original story or report.

The way that members of the executive suite look at wellness objectives is as varied as employers themselves. This month’s News You Can Use summarizes a report from WELCOA which outlines the most common types of involvement from Active Opposition to Wellness Champions.

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About The Alliance Agent and Consultant Briefing

Each month, The Alliance Agent and Consultant Briefing delivers the latest news to insurance agents and consultants about Alliance services, programs and events as well as information on health benefit trends, issues and ideas of interest to our mutual clients.

Subscriptions are available on a complimentary basis. To subscribe, please send an e-mail with your name, title and organization to the marketing and member services department.

Reader comments, suggestions and topics are always welcome.

Cathy Lanser, Editor
Tierney Jensen, Design
Diane Loram, Business Development Manager

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