Category Archives: Life, Health, Benefits

Blue Cross Blue Shield of Michigan Congratulates 39 Local Hospitals on Receiving Blue Distinction Center Designation for Quality and Efficiency

BCBSM

The Blue Distinction designation aids consumers and employers in choosing high-performing hospitals

Feb. 26, 2013, Taken from http://www.bcbsm.com/content/microsites/blue-cross-blue-shield-of-michigan-news/en/index/news-releases/2013/february-2013/bcbsm-blue-distinction-center.html

DETROIT – Blue Cross Blue Shield of Michigan today recognized 39 hospitals for the Blue Distinction Centers for Specialty Care® program in the areas of Spine Surgery and Knee and Hip Replacement. Since 2006, the Blue Distinction program has identified hospitals that deliver quality care in Bariatric Surgery, Cardiac Care, Complex and Rare Cancers, Knee and Hip Replacements, Spine Surgery and Transplants.

The Blue Distinction Centers for Specialty Care program recently expanded to include new cost-efficiency measures, as well as more robust quality measures focused on improved patient health and safety. Ten facilities in Michigan are being recognized as Blue Distinction Centers for their expertise in delivering quality specialty care in Spine Surgery or Knee and Hip Replacement, and 29 are being recognized as Blue Distinction Centers+ for their expertise in quality and cost efficiency in delivering specialty care.

Quality is key: only those facilities that first meet Blue Distinction’s nationally established, objective quality measures will be considered for designation as Blue Distinction Centers+.  This is a voluntary program, and hospitals must meet minimum criteria to earn designation.  The Blue Cross and Blue Shield Association conducts the evaluation.

In Michigan, hospitals must also participate in the Michigan Blues’ Collaborative Quality Initiative programs, when applicable, in order to earn Blue Distinction designation.  These Collaborative Quality Initiative programs have resulted in rapid quality and safety improvement in some of the most common and costly medical and surgical areas of care. In fact, four of the initiatives – focusing on general surgery, cardiac surgery, bariatric surgery and angioplasty – have resulted in cost savings of more than $232 million over three years due to avoided complications and improved safety.

“Blue Distinction Center designations, together with our award-winning Collaborative Quality Initiatives, are important hallmarks of quality and safety that consumers and employers can use when deciding where to go for certain treatments and surgical procedures,” says David Share, MD,  MPH, senior vice president, Value Partnerships, Blue Cross Blue Shield of Michigan.

These newly designated Blue Distinction Centers and Blue Distinction Centers+ demonstrate better quality and improved outcomes for patients, with lower rates of complications and readmissions than their peers. Nationally, Blue Distinction Centers+ are more than 20 percent more cost-efficient. The program provides consumers with tools to help them make better informed health care decisions. These results will also enable employers, working with their local Blue Plan, to tailor benefits to meet their individual quality and cost objectives.

A list of Michigan hospitals designated in Spine Surgery and in Hip & Knee Replacement can be found below. For more information about the Blue Distinction Program, visit www.bcbs.com/bluedistinction.

Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. For more company information, visit bcbsm.com.

The Blue Cross and Blue Shield Association is a national federation of 38 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for 100 million members – one-in-three Americans.  For more information on the Blue Cross and Blue Shield Association and its member companies, please visit www.BCBS.com.  We encourage you to connect with us on Facebook, check out our videos on YouTube, follow us on Twitter and check out The BCBS Blog, for up-to-date information about BCBSA.

Blue Distinction Centers met overall quality measures for patient safety and outcomes, developed with input from the medical community. Blue Distinction Centers+ also met cost measures that address consumers’ need for affordable healthcare. Individual outcomes may vary. National criteria is displayed on www.bcbs.com.  A local Blue Plan may require additional criteria for facilities located in its own service area.

To find out which services and providers (including hospital based physicians) are covered under your policy or to learn about Local Blue Plan criteria, contact your Local Blue Plan. Before making an appointment, be sure to contact your provider to verify its current Network and Blue Distinction Centers status. Each hospital’s Cost Index is calculated separately based on data from its Local Blue Plan. Hospitals in portions of California, Idaho, New York, Pennsylvania, and Washington may lie in areas served by two Local Blue Plans, resulting in two Cost Index figures; and their own Local Blue Plans decide whether all hospitals in these areas must meet Blue Distinction Centers+ national criteria for one or both Cost Index figures. Neither the Blue Cross and Blue Shield Association nor any Blue Plans are responsible for damages, losses, or non-covered charges resulting from Blue Distinction or other provider finder information or care received from Blue Distinction or other providers.  To find out more, contact your Local Blue Plan.

Designated Hospitals

Blue Distinction Center

Knee and Hip

  • Botsford Hospital – Farmington Hills
  • Bronson – Battle Creek
  • Chelsea Community Hospital – Chelsea
  • Henry Ford Hospital – Detroit
  • Hurley Medical Center – Flint
  • Lakeland Hospitals at Niles and St. Joseph
  • Oakwood Heritage – Taylor
  • St. John Hospital and Medical Center – Detroit
  • Sparrow Hospital – Lansing
  • William Beaumont Hospital – Grosse Pointe

Spine Surgery

  • Sparrow Hospital – Lansing
  • William Beaumont Hospital – Grosse Pointe

Blue Distinction Center+

Knee and Hip Transplants

  • Allegiance Health – Jackson
  • Borgess Medical Center – Kalamazoo
  • Bronson Methodist Hospital – Kalamazoo
  • Covenant Medical Center – Saginaw
  • Crittenton Hospital Medical Center – Rochester
  • Genesys Regional Medical Center – Grand Blanc
  • Henry Ford Macomb Hospital – Clinton Township
  • Henry Ford Wyandotte Hospital – Wyandotte
  • Holland Hospital – Holland
  • Ingham Regional Medical Center – Lansing
  • Marquette General Health System – Marquette
  • McLaren Regional Medical Center – Flint
  • McLaren Northern Michigan – Petoskey
  • MidMichigan Medical Center – Midland
  • Oakwood Hospital & Medical Center – Dearborn
  • Oakwood Southshore Medical Center – Trenton
  • Port Huron Hospital – Port Huron
  • Providence Hospital and Medical Centers – Southfield
  • St. John Macomb Oakland Hospital – Warren
  • Saint Mary’s Health Care – Grand Rapids
  • Spectrum Health Blodgett Hospital – Grand Rapids
  • Spectrum Health Butterworth Hospital – Grand Rapids
  • St. Joseph Mercy Oakland – Pontiac
  • St. Mary Mercy Hospital – Livonia
  • University of Michigan Health System – Ann Arbor
  • William Beaumont Hospital – Royal Oak
  • William Beaumont Hospital – Troy

Spine Surgery

  • Allegiance Health – Jackson
  • Borgess Medical Center – Kalamazoo
  • Bronson Methodist Hospital – Kalamazoo
  • Covenant Medical Center – Saginaw
  • Genesys Regional Medical Center – Grand Blanc
  • Henry Ford Wyandotte Hospital – Wyandotte
  • Ingham Regional Medical Center – Lansing
  • Marquette General Health System – Marquette
  • McLaren Bay Region – Bay City
  • McLaren Regional Medical Center – Flint
  • MidMichigan Medical Center–Midland
  • Port Huron Hospital – Port Huron
  • Providence Hospital and Medical Centers – Southfield
  • Saint John Hospital and Medical Center – Detroit
  • Saint John Macomb Oakland Hospital – Warren
  • Saint Mary’s Health Care – Grand Rapids
  • Spectrum Health Blodgett Hospital – Grand Rapids
  • Spectrum Health Butterworth Hospital – Grand Rapids
  • St. Joseph Mercy Hospital – Ann Arbor
  • St. Joseph Mercy Oakland – Pontiac
  • University of Michigan Health System – Ann Arbor
  • William Beaumont Hospital-Royal Oak
  • William Beaumont Hospital-Troy

Protecting Your Children – Now and for the Future

When your children are newborns, you buy baby monitors, car seats and outlet covers, trying your best to stay one step ahead from all the real (and imagined) dangers that threatened your little bundles of joy.

Then, as they grow older, your focus broadens to include schools, social activities and other influencing factors, as you do your best to keep them safe and secure. Your whole goal as a parent is to make sure your children navigate the space between birth and young adulthood as well protected as possible.

But one item might be missing from your “must have” list: life insurance. While parents typically buy life insurance for themselves for the first time, or increase the amount on existing policies when they add new members to their family, they may overlook insuring those new additions with a policy of their own.

It’s true that one function of life insurance is to protect those left behind, such as spouses or dependents, a situation that doesn’t apply when talking about minor children. But there are other reasons why it makes sense to insure your children.

1. The first comes down to dollars-and-cents: It’s far less expensive to insure a child than an adult. If the policy is convertible, meaning it can be converted from a term to a permanent policy, the insured child can theoretically have the policy for life, increasing its value, if desired, while benefiting from the cash value that is accumulating.

2. The second reason has to do with unfortunate events that could affect the long-term health of a child. While we hope and pray that are children will stay healthy, events can transpire over which we have no control. A major illness, a newly developed chronic health problem or even a catastrophic accident with permanent injuries can result in the child being considered uninsurable for life. However, if a life insurance policy was in place, especially one with a guaranteed policy purchase option for additional insurance in the future or the option to convert from term to permanent, the child will continue to be covered, regardless of what happens in terms of his or her physical health.

While it’s true that you may be able to insure your child through a group policy available through your workplace, keep in mind that changes in an employee’s group benefits may take away that option. Overall, only 19 percent of children have individual life insurance, with just 14 percent covered under group life policies, according to LIMRA, and both numbers have shown a significant decline.

Purchasing life insurance for your children is just one more way you can show your love and concern for them, and ensure that they are protected from the consequences of life’s unexpected events.

Article taken from: http://www.lifehappens.org/protecting-your-children-now-and-for-the-future/

Written by: Jaimee Niles, VP of Communications, LIFE Foundation

LETTER

Healthcare Changes Ahead: Helpful Information

Are you wondering how the health care reform law (the Affordable Care Act) will impact you or your business? I have compiled a few resources to help you learn what to expect.

 

For Individuals:

HealthCare.gov

is an excellent source to learn about what will be changing and when you can expect those changes to occur. Here is a breakdown of the changes ahead for 2013 and beyond, as listed on http://www.healthcare.gov/law/timeline/full.html.

2013

IMPROVING QUALITY AND LOWERING COSTS

  • Improving Preventive Health Coverage. To expand the number of Americans receiving preventive care, the law provides new funding to state Medicaid programs that choose to cover preventive services for patients at little or no cost. Effective January 1, 2013.Learn more about the law and preventive care.
  • Expanding Authority to Bundle Payments. The law establishes a national pilot program to encourage hospitals, doctors, and other providers to work together to improve the coordination and quality of patient care.  Under payment “bundling,” hospitals, doctors, and providers are paid a flat rate for an episode of care rather than the current fragmented system where each service or test or bundles of items or services are billed separately to Medicare.  For example, instead of a surgical procedure generating multiple claims from multiple providers, the entire team is compensated with a “bundled” payment that provides incentives to deliver health care services more efficiently while maintaining or improving quality of care.  It aligns the incentives of those delivering care, and savings are shared between providers and the Medicare program. Effective no later than January 1, 2013.

 

INCREASING ACCESS TO AFFORDABLE CARE

  • Increasing Medicaid Payments for Primary Care Doctors. As Medicaid programs and providers prepare to cover more patients in 2014, the Act requires states to pay primary care physicians no less than 100% of Medicare payment rates in 2013 and 2014 for primary care services. The increase is fully funded by the federal government. Effective January 1, 2013.Learn how the law supports and strengthens primary care providers.
  • Providing Additional Funding for the Children’s Health Insurance Program. Under the law, states will receive two more years of funding to continue coverage for children not eligible for Medicaid. Effective October 1, 2013.Learn more about CHIP.

2014

NEW CONSUMER PROTECTIONS

A chain of blue paper dolls forms a circle with one orange paper doll
  • Prohibiting Discrimination Due to Pre-Existing Conditions or Gender. The law implements strong reforms that prohibit insurance companies from refusing to sell coverage or renew policies because of an individual’s pre-existing conditions. Also, in the individual and small group market, the law eliminates the ability of insurance companies to charge higher rates due to gender or health status. Effective January 1, 2014.Learn more about protecting Americans with pre-existing conditions.
  • Eliminating Annual Limits on Insurance Coverage. The law prohibits new plans and existing group plans from imposing annual dollar limits on the amount of coverage an individual may receive. Effective January 1, 2014.Learn how the law will phase out annual limits by 2014.
  • Ensuring Coverage for Individuals Participating in Clinical Trials. Insurers will be prohibited from dropping or limiting coverage because an individual chooses to participate in a clinical trial.  Applies to all clinical trials that treat cancer or other life-threatening diseases. Effective January 1, 2014. 

 

IMPROVING QUALITY AND LOWERING COSTS

  • Making Care More Affordable. Tax credits to make it easier for the middle class to afford insurance will become available for people with income between 100% and 400% of the poverty line who are not eligible for other affordable coverage. (In 2010, 400% of the poverty line comes out to about $43,000 for an individual or $88,000 for a family of four.) The tax credit is advanceable, so it can lower your premium payments each month, rather than making you wait for tax time. It’s also refundable, so even moderate-income families can receive the full benefit of the credit. These individuals may also qualify for reduced cost-sharing (copayments, co-insurance, and deductibles). Effective January 1, 2014. Learn how the law will make care more affordable in 2014.
  • Establishingthe Health Insurance Marketplace. Starting in 2014 if your employer doesn’t offer insurance, you will be able to buy it directly in the Health Insurance Marketplace. Individuals and small businesses can buy affordable and qualified health benefit plans in this new transparent and competitive insurance marketplace. The Marketplace will offer you a choice of health plans that meet certain benefits and cost standards. Starting in 2014, Members of Congress will be getting their health care insurance through the Marketplace, and you will be able buy your insurance through Marketplace too. Learn more about the Health Insurance Marketplace.
  • Simple comparison of two coverage options
  • Increasing the Small Business Tax Credit. The law implements the second phase of the small business tax credit for qualified small businesses and small non-profit organizations. In this phase, the credit is up to 50% of the employer’s contribution to provide health insurance for employees.  There is also up to a 35% credit for small non-profit organizations.  Effective January 1, 2014.Learn more about the small business tax credit.

 

INCREASING ACCESS TO AFFORDABLE CARE

  • Increasing Access to Medicaid. Americans who earn less than 133% of the poverty level (approximately $14,000 for an individual and $29,000 for a family of four) will be eligible to enroll in Medicaid. States will receive 100% federal funding for the first three years to support this expanded coverage, phasing to 90% federal funding in subsequent years. Effective January 1, 2014.Learn more about Medicaid.
  • Promoting Individual Responsibility. Under the law, most individuals who can afford it will be required to obtain basic health insurance coverage or pay a fee to help offset the costs of caring for uninsured Americans.  If affordable coverage is not available to an individual, he or she will be eligible for an exemption. Effective January 1, 2014.Learn more about individual responsibility and the law.

2015

IMPROVING QUALITY AND LOWERING COSTS

  • Paying Physicians Based on Value Not Volume. A new provision will tie physician payments to the quality of care they provide. Physicians will see their payments modified so that those who provide higher value care will receive higher payments than those who provide lower quality care. Effective January 1, 2015.

 

For Businesses:

The U.S. Small Business Administration is launching a new series to explain the basics of the law, what you need to do to comply, and how your business can benefit from new incentives. The first article in the series, written by Meredith Olafson, highlights three big things every small business owner should know about the Affordable Care Act.

About the Author

Meredith Olafson is Senior Policy Advisor for the U.S. Small Business Administration where she oversees the agency’s education and outreach efforts around health care and the Affordable Care Act.

The Affordable Care Act will help small businesses by lowering premium cost growth and increasing access to quality, affordable health insurance.   Depending on whether you’re a small employer or a larger employer, different provisions of the Affordable Care Act may apply to you as described below.

1.  Businesses with Fewer than 25 Employees- Small Business Tax Credits

The Affordable Care Act does not require that businesses provide health insurance, but it offers tax credits for eligible small businesses that choose to provide insurance to their employees.  To qualify for a small business tax credit of up to 35% (up to 25% for non-profits), you must have:

  • Fewer than 25 full-time equivalent employees
  • Pay average annual wages below $50,000
  • Contribute 50% or more toward employee health insurance premiums

Beginning in 2014, this tax credit goes up to 50% (35% for non-profits) and is available to qualified small businesses who participate in the Small Business Health Options Program (SHOP) Exchanges.

2.   Businesses with 50 or Fewer Employees- Affordable Insurance Marketplaces

The Affordable Care Act does not require that businesses provide health insurance, but beginning in 2014, small businesses with generally 50 or fewer employees will be able to purchase coverage through SHOP , competitive marketplaces where small employers can go to find health coverage from a selection of providers.  The SHOP Marketplaces and Individual Marketplaces for those who are self-employed open on January 1, 2014. Open enrollment begins on October 1, 2013.  SHOP will offer small businesses increased purchasing power similar to that of large businesses.

3.  Businesses with 50 or More Employees- Employer Shared Responsibility Provisions

Under the Affordable Care Act, the Federal government, State governments, insurers, employers, and individuals share the responsibility to reform and improve the availability, quality, and affordability of health insurance coverage in the United States. Employers are not required to provide coverage to their employees under the Affordable Care Act.   However, beginning in 2014, businesses with 50 or more full-time employees (or full-time equivalents) that do not offer affordable health insurance that provides a minimum level of coverage to substantially all of their full-time employees (and their dependents) may be subject to an employer shared responsibility payment if at least one of their full-time employees receives a premium tax credit to purchase coverage in an insurance Marketplace.  A full-time employee is generally one who is employed an average of 30 or more hours per week.

If you meet or are close to this threshold level of full-time employees, it’s important to understand how these rules may apply to you and how the employer shared responsibility payments could be triggered.   For more guidance on the employer shared responsibility payments, refer to this FAQ from the IRS.

Check back with the Reno Agency blog for more updates about the Affordable Health Care Act as they become available.

Make Sure You Are Covered In 2013

Since we’ve begun a new year, it’s time to reflect on the year prior to make sure your insurance policies are updated to reflect any life changes you may have gone through. Here are some tips from once of our carriers, Grange Insurance: Grange Insurance Hi Res Version

1. Save Money.

In the new year, your insurance company may release new offerings, such as coverages or services of which you can take advantage and from which you can benefit. Your insurance provider may also offer new discounts, or you may now be eligible for discounts that you were not eligible for in 2012.
“Talk with your local independent agent to see what new options may be a good fit for you and where life will take you in 2013,” said John Ammendola, president, Grange Personal Lines. “Oftentimes, policyholders find that by making changes or bundling two policies under the same provider, such as homeowners and auto, they can save money. Reviewing these options is a great way to make sure you’re getting the most out of your insurance policy, whether it covers your home, car or even your life.”

2. Review the Past Year’s Events.

Perhaps you tied the knot in 2012 or purchased a new home. Whatever your major life change, you should ensure that your policy coverage is updated to properly protect your family and your assets.
When reviewing your policy, Ammendola suggests considering these important factors:

 

  • Did you make improvements or renovations to your home? If yes, you may need to increase your dwelling limit to ensure you have adequate coverage in an event of a fire or other damage to your home.
  • Did you purchase something of a significant value? If yes, consider increasing your contents coverage to ensure it is properly covered in the case of theft or damage.
  • Do you have a newly licensed driver? If yes, it may be a good idea to consider an umbrella policy – a policy designed to provide additional liability protection on both your homeowner and auto policies.
  • Did you get married or divorced? If yes, then you may need to add/remove your spouses name to your policies, purchase life insurance or change beneficiaries on your current policy.

3. Insure your Holiday Gifts.

If the holidays bring sparkly gifts, then review your homeowners or renters insurance policy to make sure you have adequate coverage for your new valuables.
“Oftentimes, under standard homeowners or renters insurance, gifts such as jewelry, watches, coins, hand tools and guns have coverage limitations,” said Ammendola. “It is important to check your policy for these value limitations and, if needed, purchase broader coverage to ensure your gifts are properly covered in the case of theft, fire or damage.”

Call the Reno Agency today at 269.792.2232 to schedule your insurance review to make sure there are no gaps in coverage on your insurance policies.

Why Your Business Should Implement a Health & Wellness Program for Employees

It’s the beginning of a new year, and with that brings the numerous resolutions that will be made (and broken) before the end of January. The number one resolution always seems to be, ‘get healthy’. And why wouldn’t you want to? There are many benefits to good health including taking less medications, less doctor/hospital visits, and oh yeah, lower insurance costs.

If you are a small business owner, answer this question: Does your company offer your employees a health and wellness Program? If no, why not? Health insurance premiums are always increasing it seems, and if you could offer a way to help maintain those premiums, or even lower those premiums, wouldn’t you consider a program such as this?

The U.S. Small Business Administration provides the why and how to implement a health and wellness program in your small business. Read an excerpt from the article, “Why and How to Implement a Health and Wellness Program in Your Small Business” below. For the full article, visit http://www.sba.gov/community/blogs/community-blogs/small-business-cents/why-and-how-implement-health-and-wellness-progr

Tips for Implementing Health and Wellness Programs in Your Small Business

So how can you go about planning and implementing a program that makes sense for your business, with the limited resources available to you? Health and wellness plans don’t have to break the bank. With a bit of creativity there are many things you can do to keep employees health and happy.

Here are a few tips:

Talk to your employees. Find out what aspects of an employer-sponsored health and wellness plan they would value most. It could be discounted gym memberships, quarterly sponsored walks/runs, or employee-led healthy cooking workshops. maybe it’s just more awareness of free or low-cost preventative care options covered by your healthcare insurance plan.

Get ideas for your wellness program. This blog from former SBA guest blogger, Dawn Rivers Baker, offers some creative and engaging ideas for a low-cost or no-cost employee wellness program.

Get help structuring specific programs. The Centers for Disease Control provides some great online tools to help you design and structure your wellness programs. For example, CDC LEAN Works is a free web-based resource that can help employers design effective worksite obesity prevention and control programs, including an obesity cost calculator to estimate how much obesity is costing your company and how much in savings your company could reap with different sorts of workplace interventions.

Consult your healthcare insurance provider. Many now offer tools and resources to help employers develop programs. Familiarize yourself with the types of programs that make sense for your business.

Get help from small business assistance groups. Check in with your local Small Business Development Center or Chamber of Commerce. They may have resources or seminars that can help you build the right program for your business.

 

Another great read from the U.S. Small Business Administration on how to reduce the cost of health insurance can be found here.

Let’s start off 2013 with a commitment to live healthy! Make small changes, take small steps, and soon enough you will see big results.

President Obama’s Health Care Overhaul is in a Sprint to the Finish Line

Whether you are for or against President Barack Obama’s health care overhaul, the main question now is not “Will it happen,” but “How will they make it happen.” There are 11 months left before millions of uninsured Americans are able to get health care coverage, but there are still many questions about how the President will execute those plans. Here is an article from InsuranceNewsNet.com that provides an update to where we are now, and what has to be done over the next several months to implement a successful transition.

http://insurancenewsnet.com/article.aspx?id=363551&type=LifeHealth&inl=1#.UKEV_JITXVQ

Medicare Open Enrollment is Now Through December 7

Are you turning 65 soon and need help finding a Medicare plan? Are you 65+ and want to see if you can save money by switching Medicare plans? Or do you have a disability that qualifies you for Medicare? Open enrollment for Medicare is now through December 7, and if you have questions, the Reno Agency is here to assist. Call us today at 269.792.2232 to schedule your appointment.

In the meantime, www.medicare.gov is an excellent place to start if you have questions.

In Michigan, both Blue Cross Blue Shield and Priority Health have expanded their Medicare products. Read the full articles here to find out more information.

http://news.bcbsm.com/news/2012/news_2012-10-18-11174.shtml

http://www.priorityhealth.com/about-us/press-room/releases/2012/medicare-2013-expansion