Valeant: A Pharmaceutical Enron?; Having The Talk; Financial Cliffs and Family Glitches; November is Diabetes Awareness Month…

October 27, 2015

During last week’s member meeting,  the first guest speaker asked how many people in the room had dealt with end-of-life care issues on behalf of a loved one. Virtually every hand shot up. Look for a blog with meeting details in next week’s Express — and members will have access to new employee communications tools that will help them open conversations about end-of-life care in their organizations.

Weekly Buzz: Opening Conversations about End-of-life Care

Talking about end-of-life care needn’t be difficult, especially if you start the conversation when all is well. This was among the key messages during last week’s member meeting where the goal was to increase awareness and understanding among employers about advance care planning and end-of-life care to enable them to support employees in dealing with these issues. Members may access the meeting presentations by clicking on “See All Presentations” from The Action Group’s homepage. Many resources are also available online:


Media Pressure on Stunning Drug Costs Still Escalating  


cf56bbd0-af94-4929-af76-e390d4a0d50fGetting Started with Healthy Choices

Consumer Reports has brand-new, evidence-based employee communications resources for your employees. Making Healthy Choices offers advice about how to be a smart consumer in today’s health-care marketplace. The tools help employees engage with their health-care providers, enabling them to choose the high-quality care they need while avoiding unnecessary services they don’t.

Among the new materials are stories about real patients who are discovering how to avoid costly, and even harmful, medical care are now available from Consumer Reports and Choosing Wisely®.

To view Action Group tools and resources that enable employers to take action to lower the incidence and cost of diabetes, click here.

healthy-story


mn-health-care-task-forceHealth Care Financing Task Force Update

The Health Care Financing Task Force and its subgroups continue to meet and discuss policy options to present to the 2016 Legislature. At the most recent Task Force meeting last Friday in Rochester, the parameters of the reform discussion started to come into sharper focus.

Affordability of insurance has been highlighted as one of the largest barriers to care, including the so-called “Financial Cliff,” the “Family Glitch,” and how to deal with high-deductible Qualified Health Plans (QHPs) in the marketplace.

The Financial Cliff:  Data show that at 200 percent of the federal poverty limit (FPL) the cost of premiums increases dramatically for Minnesotans. Some possible recommendations the group is considering include:

  • Establishing voluntary Health Savings Accounts for consumers in MA/MinnesotaCare
  • Expanding eligibility for enhanced subsidies to consumers at 200-275 percent FPL
  • Redistributing federal subsides (in the form of tax credits) to improve affordability

The Family Glitch: Some consumers are precluded from obtaining federal tax credits for coverage through MNsure because they were determined eligible for employer-sponsored coverage. As affordability levels for employer plans are based off of individual and not family coverage, the reality can be cost prohibitive. While no state has yet solved the “Family Glitch” puzzle, partially due to the potential costs involved, the Task Force is looking at developing a Minnesota Affordability Scale to help sharpen their evaluations going forward.

High-Deductible QHP Products: Discussions have revolved around requiring carriers to offer low or no-deductible health plan options, or exempting certain services from deductible requirements. Such exemptions may involve more preventive care and increased use of generic drugs.

While most of the conversations have revolved around dollars, Task Force members realize that certain structural changes may be necessary as well. Improved alignment of eligibility rules and benefits, such as consolidation of MinnesotaCare with either the private marketplace or the Medical Assistance program has been discussed at a high level.

The Task Force will continue to refine its options through November, with early December targeted for final shaping of recommendations. Final recommendations are due to the Legislature by January 15, 2016. For more information about the Task Force, including a presentation on value-based purchasing models, please visit their website.


  • Nearly 30 million U.S. children and adults have diabetes.
  • Another 86 million Americans have prediabetes and are at risk fo developing type 2 diabetes.
  • The American Diabetes Association estimates that the total national cost of diagnosed diabetes in the United States is $245 billion.

November is Diabetes Awareness Month! 

American Diabetes Month® (ADM) takes place each November and is a time to come together as a community to Stop Diabetes.

The vision of the American Diabetes Association is a life free of diabetes and its burdens. Raising awareness of this ever-growing disease is one of the main efforts behind the mission of the Association. ADM is an important element in this effort, with programs designed to focus the nation’s attention on the issues surrounding diabetes and the many people who are affected by the disease.

To learn more, or to access free newsletter articles, fact sheets, and posters (available in English and Spanish), click here. To learn more about new evidence linking smoking cessation to lowered diabetes risk, click here.

 


Thought for the Week

“There are huge gaps when it comes to having ‘The Talk’ about end-of-life care. While doctors and patients agree it’s important to discuss patient wishes, many patients and their families believe their doctors will start the talk, while many doctors believe their patients will begin the conversation. Because each is waiting for the other, these conversations often don’t occur at all. It’s very stressful for all. But not having the conversation makes it even more stressful when the time comes.”

Jennifer Lundblad, President and CEO of Stratis Health