MEDICARE:
Medicare’s Push To Improve Chronic Care Attracts Businesses, but Not Many Doctors
Carrie Lester looks forward to the phone call every Thursday from her doctors’ medical assistant, who asks how she’s doing and if she needs prescription refills. The assistant counsels her on dealing with anxiety and her other health issues.
Lester credits the chats for keeping her out of the hospital and reducing the need for clinic visits to manage chronic conditions including depression, fibromyalgia, and hypertension.
“Just knowing someone is going to check on me is comforting,” said Lester, 73, who lives with her dogs, Sophie and Dolly, in Independence, Kansas.
At least two-thirds of Medicare enrollees have two or more chronic health conditions, federal data shows. That makes them eligible for a federal program that, since 2015, has rewarded doctors for doing more to manage their health outside office visits.
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A New Use for Wegovy Opens the Door to Medicare Coverage for Millions of People with Obesity
The FDA recently approved a new use for Wegovy (semaglutide), the blockbuster anti-obesity drug, to reduce the risk of heart attacks and stroke in people with cardiovascular disease who are overweight or obese. Wegovy belongs to a class of medications called GLP-1 (glucagon-like peptide-1) agonists that were initially approved to treat type 2 diabetes but are also highly effective anti-obesity drugs. The new FDA-approved indication for Wegovy paves the way for Medicare coverage of this drug and broader coverage by other insurers. Medicare is currently prohibited by law from covering Wegovy and other medications when used specifically for obesity. However, semaglutide is covered by Medicare as a treatment for diabetes, branded as Ozempic.
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Humana warns of tough times ahead for Medicare Advantage
The Louisville company remains bullish on long-term prospects for its core business
LOUISVILLE, Ky. (WDRB) — Louisville-based Humana Inc. warned investors of tough times ahead in the next few years for Medicare Advantage, even as the company maintains that its bread-and-butter business will recover in the long term.
On April 24, Humana backed off its 2025 profit targets for the second time since January, citing the federal government’s planned payments to Medicare Advantage plans as well as regulatory changes.
Humana and other insurers have said the Medicare Advantage payments will not keep pace with rising costs from senior citizens using their benefits for hospital stays, outpatient procedures and other medical costs.
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GROUP:
Strong Economy, Low Unemployment, and Higher Job and Wage Growth Extend Social Security Trust Funds to 2035
The Social Security Board of Trustees today released its annual report on the financial status of the health of the Social Security Trust Funds. The combined asset reserves of the Old-Age and Survivors Insurance and Disability Insurance (OASI and DI) Trust Funds are projected to have enough dedicated revenue to pay all scheduled benefits and associated administrative costs until 2035, one year later than projected last year, with 83 percent of benefits payable at that time.
In the 2024 Annual Report to Congress, the Trustees announced:
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New Overtime Rule Raises Salary Level in Two Phases
The U.S. Department of Labor’s (DOL’s) two-part approach to implementing its new overtime rule—establishing one raise of the salary-threshold level on July 1 and another on Jan. 1, 2025—gives employers options for adjusting the pay of their exempt employees.
Effective July 1, the Fair Labor Standards Act’s (FLSA’s) annual salary-level threshold for white-collar exemptions to overtime requirements will increase from $35,568 to $43,888. As of Jan. 1, 2025, the annual salary threshold will rise to $58,656.
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A Guidebook to Getting Your Employee Retention Strategy Right
High employee turnover can be a tiring and costly uphill battle for businesses.
Despite dedicating considerable time, effort, and resources to finding suitable candidates, the challenge of retaining talent can be persistent.
This perpetual cycle of hiring and training employees strains finances, impedes cultural development, and can directly affect customer satisfaction.
In this guidebook, you’ll find everything you need to fix high employee turnover with the right employee retention strategy, including:
The actual costs of high turnover
The fundamentals of effective employee retention
The importance of ongoing employee development
How to use technology to enhance retention efforts
How to implement a streamlined hiring process
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Moving beyond financial incentives to engage specialists in ACOs
The biggest challenge ACOs face is the lack of good data on specialist performance, says study author Rob Mechanic.
Accountable Care Organizations are struggling to find specialists to improve value-based care, although it is a top priority Centers for Medicare and Medicaid Services.
Meanwhile, ACOs face considerable challenges in effectively engaging specialists, according to a recent study from the Institute for Accountable Care in the American Journal of Managed Care.
The predominant influence of fee-for-service payment structures on specialist behavior was cited as a major hurdle by 58% of ACOs.
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Americans need more sleep, less stress, experts say, as Gallup poll reveals troubling findings
Stress and sleeplessness are ‘connected,’ say experts, who share tips to address the issues
Many Americans are getting too little sleep and have too much stress.
A new Gallup poll revealed 57% of adults would “feel better if they got more sleep,” while 42% said they get “as much sleep as they need.”
These findings have nearly reversed in the last decade, Gallup noted in a press release. The last measurement in 2013 found that 56% of Americans got the sleep they needed while 43% did not.
Overall, however, Americans are getting fewer hours of sleep than they did in past decades.
In 1942, 59% of Americans were getting eight hours or more of sleep per night, while only 3% were getting five hours or less.
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INDUSTRY CALENDAR
2024 CONFERENCES
- May 13-15, CAHIP Capital Summit @ Kimpton Sawyer Hotel, Sacramento, Register:
- June 23-26, Society for Human Resources Management SHRM24 Annual Conference and Expo @ Chicago, Register:
- August 28 2024 SAHU Business Medicare Expo, @ 8:00 am-4:00pm, Save the Date
- October 6-8 NAIFA e3 Conference @ Sonesta Redondo Beach & Marina, Register:
May
- May 15 @9:30AM-12:00AM Mental Health Awareness Month-Membership Meeting, @ The Odyssey 15600 Odyssey Dr., Granada Hills, Register:
- May 16: SAHU Golf Tournament @ The Ridge Golf Club, Get Tickets:
Virtual Trainings:
- May 14@ 1:00pm-4:00pm, NABIP Live Virtual Self-Funded Certification Course, Register:
- May 21@ 1:00 PM – 2:00pm, Health Net Market Insights Webinar, Register:
- May 22 @ 11:00 pm -1:00 pm, CAHIP San Diego Medicare Roundtable, Register:
- May 23 @11:30 am-1:00 pm NAIFA LA Disability Plans with Petersen Int’l., Register:
- May 23 @3:30 pm-6:00pm CAHIP San Diego Legislative Update Meeting @ Riverwalk Golf Club 1150 Fashion Valley Road, Register:
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